I am a pediatric hospitalist in middle America. I believe in you, and I hope that you believe in me. Many of my patients’ parents do not believe in me, you see, and it makes it hard for me to do my job and to take care of these children in the way that I have been trained and believe to be in their best interest.

A toddler has just died because of his amber teething bead necklace. More and more of my patients are unvaccinated or under-vaccinated, putting them at risk for preventable infections and putting our immunocompromised patients at even greater risk. Many of my patients are exposed to second-hand smoke or illicit drugs or spend their days in situations where they are abused or neglected. Sometimes I can’t discharge my patients because there is nowhere safe for them to go.

I wish that the biggest conundrum we faced was how to provide our patients with presents during the holiday season. My group has addressed this issue with some of our patients; it is a small thing we can do with our financial resources that we hope makes a difference in the lives of those less fortunate.

But what will happen to them next month? Next year? After the holiday lights have dimmed, the bells have been silenced. Who will be their champion?

As we do our best to discharge as many patients as possible for the holidays, are we really doing them a service? We would like to believe that our kids want to be at home with their families, but what about the children who have no families, who have no homes? Maybe being in the hospital provides them with heat, a bed, and three meals a day. For some of them, maybe being in the hospital provides them with caregivers and electricity and with someone who asks them how they are doing at least twice a day.

This is the season of miracles. When you visit each house against all odds. When cancer is cured. When every child is given a chance, despite the unfavorable situation into which he or she was born. When my cynical instincts about my patients’ parents are proven incorrect. When everyone rises to the occasion and does their best by those who are depending upon them.

Yes, Virginia, there is a Santa Claus. She is working on December 25th and spends a few extra minutes holding the baby on the 4th floor who is all alone in her crib. This Santa arranges a donation campaign for the custodian with a speech impediment who goes out of her way to empty the trash in the hospitalists’ office, even on the weekends. The same Santa collects clothing and gifts for a delinquent teenager who is stuck in the hospital for months, even when this patient is written off by many others as a criminal who isn’t worth saving.

While we scurry about buying gifts for our own children and families, it does not go unnoticed that there are children and families who are stuck in the hospital for a myriad of reasons. Some of those reasons are due to exceptionally bad fortune and others seem to be due to the psychosocial failures of the children’s caregivers. But whatever the reason, Santa, the result is that an innocent child is spending what should be the most joyful time of the year in the hospital. And no matter how hard the Child Life staff and nurses and physicians try, being in the hospital on Christmas is never preferable to being at home.

Please, help us to get everyone possible to a safe home situation. And when that is not possible, please help us to bring your spirit to our patients. We may not be thrilled to be working the holiday shifts, but please help us to realize that our patients are no thrilled to be hospitalized during the holidays.

We could all use a little magic right now.

Lisa Sieczkowski is a pediatrician. 

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